Provider Demographics
NPI:1235150665
Name:LUCIUS, DAMIEN A (DPM)
Entity Type:Individual
Prefix:MR
First Name:DAMIEN
Middle Name:A
Last Name:LUCIUS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:258 MAIN ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2525
Mailing Address - Country:US
Mailing Address - Phone:508-478-6700
Mailing Address - Fax:508-473-4036
Practice Address - Street 1:258 MAIN ST
Practice Address - Street 2:SUITE 212
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2525
Practice Address - Country:US
Practice Address - Phone:508-478-6700
Practice Address - Fax:508-473-4036
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2314213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY75162Medicare ID - Type Unspecified